Carbon monoxide posioning

End

Urgent investigation (ECG, CXR, ABG, COHb)

Inhalation of car exhaust fumes
Inadequately maintained or ventilated heating systems (including those using natural gas)
Smoke from any fire
Methylene chloride in paint stripper

Conscious

Oxygen 100%
Tightly fitting facemask
Circuit minimizing rebreathing

Unonscious

Intubate and mechanically ventilated with oxygen 100%

Significant CO poisoning excluded
Assume other diagnosis

Carboxyhemoglobin (COHb) level?

COHb < 10%

COHb >10%

Contact National Poisons Information Service (in UK) to discuss management and for location of nearest center for hyperbaric oxygen therapy

Supportive care

Indication for hyperbaric oxygen?

Yes

No